Orvosi hetilap · 2025
[Morbidity and mortality indicators of diabetic peripheral artery vascular patients in a general practice].
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Galvács Henrietta, Mongel Istvánné, Dózsa Katalin
Аннотация
Introduction: Diabetes mellitus is one of the most serious public health problems today. Among its target organ complications, cardiovascular diseases stand out. Among these, one of the most significant diseases is lower extremity peripheral artery disease. Objective: The aim of this study was to assess the prevalence, risk factors and risk of lower limb peripheral artery disease in patients with carbohydrate metabolism disorder attending a preventive care office in a general practice, compared with non-diabetic patients. Method: Between 01. 06. 2021 and 31. 05. 2024, we evaluated the anthropometric data, comorbidities, and ankle-brachial index results of patients who attended the preventive care office, using the general practice software, comparing diabetic and non-diabetic patients. Results: During the examined period, 522 care events took place, involving 423 patients. A significant difference was found between the waist circumference (p<0.001) and BMI values (p<0.001) of diabetic and non-diabetic patients. Cardiovascular diseases also occurred significantly more frequently (p<0.001) in diabetes. In addition to male gender (p = 0.041), smoking (p = 0.034), diabetes duration (p = 0.018), fasting blood glucose level (p = 0.039), chronic coronary artery disease (p<0.001), chronic kidney disease (p = 0.041), dyslipidemia (p = 0.021), and pre-existing carotid plaque/stenosis (p = 0.002) showed significant influencing effects on the development of peripheral artery disease. The risk of developing peripheral artery disease is already increased in diabetic patients from the age of 45 years, and by the age of 70 years, the majority of patients may be dead. Discussion: Lower extremity peripheral artery disease and other known cardiovascular conditions occurred significantly more frequently in diabetic patients. Most of them can be considered polyvascular patients due to the involvement of other localizations (carotid system and coronary arteries). Due to the confirmed comorbidities, a holistic approach is necessary in primary care, an important part of which is achieving cholesterol target levels. Conclusion: In order for prevention to be more successful, it is necessary to involve additional professionals in the primary care of diabetic patients as soon as possible, in the spirit of task delegation. In the screening of chronic diseases, patient education, and care to the target value, advanced practice nurses can provide effective assistance, making their prompt integration fundamentally important. Orv Hetil. 2025; 166(23): 913–920.